CELLULAR IMMUNE FUNCTION IN AIDS AND IN PRIMARY IMMUNE DEFICIENCIES

外周血中发现的辅助性T细胞(Th)缺陷谱 无症状HIV阳性(HIV+)患者的血白细胞(PBL) 现在被发现可以预测艾滋病诊断的时间和时间 死亡。Th缺陷的光谱似乎可归因于 从Th1对Th2功能的优势转变为Th1对Th2的优势 Th2胜过Th1的功能。因此，Th1功能可能是保护性的 而Th2并非如此。 参展的个人和个人队列的数量 针对HIV抗原但血清阴性的T细胞活性仍在继续 来成长和扩张。目前，在接触过艾滋病毒但血清呈阴性的人群中 个体HIV特异性Th反应个体的百分比为：同性恋 男性，63%；静脉注射吸毒者，45%；意外暴露的医疗保健 工人，75%；血友病患者幸存者，19%；以及感染艾滋病毒的新生儿- 受感染的母亲，35%。这些人中的大多数仍然 随访结果为阴性，但也有少数人的HIV DNA检测呈阳性。 以上总结的研究提出了细胞 由Th1细胞介导的免疫是保护性的，但体液免疫， 由Th2细胞介导的则不是。如果是正确的，这些发现将表明 艾滋病疫苗的开发应该指向增强细胞 而不是体液免疫。

The spectrum of T helper cell (Th) defects observed in the peripheral blood leukocytes (PBL) of asymptomatic HIV-seropositive (HIV+) individuals has now been found to be predictive for time to AIDS diagnosis and time to death. The spectrum of Th defects appears to be attributable to a reversal from a predominance of Th1 over Th2 function to a predominance of Th2 over Th1 function. Thus it maybe that Th1 function is protective whereas Th2 is not. The numbers of individuals and of cohorts of individuals who exhibit potent T activity against HIV antigens but who are seronegative continue to grow and expand. At present, among HIV-exposed but seronegative individuals the percent of HIV-specific Th responsive individuals are: gay men, 63%; intravenous drug users, 45%; accidentally-exposed health care workers, 75%; surviving exposed hemophiliacs, 19%; and newborns of HIV- infected mothers, 35%. The majority of these individuals remains seronegative on follow-up, although a few are PCR+ for HIV DNA. The studies summarized above raised the possibility that cellular immunity, mediated by Th1 cells, is protective, but humoral immunity, mediated by Th2 cells is not. If correct, these findings would indicate that AIDS vaccine development should be directed to augment cellular rather than humoral immunity.